Practical, Proven, and Surprising Solutions for Your Sleep Problems
An Interview With Diane Macedo
ABC News anchor/correspondent Diane Macedo’s new book is titled The Sleep Fix: Practical, Proven, and Surprising Solutions for Insomnia, Snoring, Shift Work, and More.
As an early-morning reporter and overnight news anchor, former insomniac Diane Macedo knows how valuable sleep is. Here she discusses her book The Sleep Fix, billed as “a perfect mix of hard science and self-help.”
S&H: What’s the difference between being sleepy, tired, and fatigued?
Diane Macedo: When you feel sleepy, you’re essentially struggling to stay awake. Your eyelids feel heavy, your head might feel heavy.
Fatigue, on the other hand, is what you feel after a tough workout, a difficult task, or if you’re stressed out over something—including not sleeping. You feel drained, as opposed to feeling like you can’t keep your eyes open. And it is possible to be both fatigued and sleepy. But if you’re only fatigued you need rest, not sleep. This is important because many of us with insomnia make the mistake of going to bed when we feel “tired” but not sleepy, then we end up awake and frustrated in bed, which makes our insomnia worse.
Explain briefly the importance of a sleep diary and how to create one.
To find the right sleep solutions that are actually going to work for you, you have to first figure out what it is that’s keeping you awake, and a sleep diary is a great tool to help with that.
You can buy one, print one, use an app, or just use a regular notebook, and the idea is to log daily information about your sleep: what time you went to bed, what time you think you fell asleep, how many times you woke up in the night, what time you woke up for the day, and so on. You can also log your caffeine intake, if/when you worked out—anything you think might be affecting your sleep.
After a few days you’ll likely start to notice patterns in your diary that help to shed light on what’s causing or contributing to your sleep problems, which then helps you pick the best solutions to address them. Interestingly, it can also help to quickly improve your habits; you don’t want to write down that you stayed up until 2 a.m. playing Candy Crush, so you stop doing it. And even if you don’t find it to be a good a self-help tool, a sleep diary provides you with a body of evidence to present to a sleep specialist to help them better diagnose and treat you.
How does the myth of the quiet mind impede one’s ability to get to sleep?
Arguably the most common reason people (including myself) cite for difficulty sleeping is some variation of “I can’t shut off my mind.” But here’s the thing: nobody can! Even when we’re sleeping, our minds are incredibly active. As my colleague and meditation expert Dan Harris once told me, “Let go of this idea of clearing your mind. That doesn’t happen unless you are enlightened or you have died.”
When we do fall asleep it’s not because our mind finally switches off, it’s because our sleep drive overpowers our wake drive. But when we buy into the myth of the “quiet mind” we sometimes create our own problem, because our worries about thinking and our efforts to stop thinking power up our wake drive, which makes it harder for our sleep drive to compete.
Of all the fixes you recommended to help one get to sleep, what are the most pertinent ones you’d like to share with S&H readers?
For anyone who struggles with racing thoughts and worries at bedtime, I love a technique called constructive worry, or a brain dump. You just take a notebook, divide a page down the center, and on the left make a list of anything that’s on your mind. On the right side, write down the very next step to resolving that issue. This might be as simple as “call [so and so] to ask for advice” or “look up info on X website.” If the issue is completely out of your hands, write down “accept and move on.” When you run out of things to write down, you’re done.
I was so skeptical about this, but it’s generally effective for a number of reasons, one being that by processing your thoughts and feelings before bed you alleviate the need to do that in bed. After about two weeks I didn’t even need to write anything down. It felt like my brain started doing it automatically and also finally understood: Head on pillow means it’s time to sleep, not time to stay awake and worry.
Another thing that really helped me is what I think should be the golden rule of sleep: If you are ever in bed and feeling frustrated, get out of bed, do something enjoyable and relaxing (I recommend starting with a brain dump), and come back to bed when you feel more sleepy. This helps re-establish that bed is for sleeping, not worrying, and for me leaving bed kind of took the pressure off, which helped me calm down much faster than if I were to stay in bed trying to force myself to sleep.
Finally, I’ll go with the simple but little-known fact that waking up a lot throughout the night can be a sign that you have sleep apnea. This is important because many doctors just assume it’s insomnia and prescribe a sleeping pill, which is a problem because a) sleeping pills are not the gold standard treatment for insomnia, and b) sleeping pills can make the sleep apnea worse, which can be downright dangerous.
It’s also very possible to have both sleep apnea and insomnia, in which case you’ll have to treat both (but that still generally should not involve sleeping pills).
For those who are traveling long distances, any recommendations for reducing jet lag?
Bright light therapy is most effective, provided your doctor says it’s safe for you. You can use the sun for this or get a portable therapy light. If traveling east, expose yourself to 30 minutes of bright light (ideally sunlight) at your wake-up time in your original time zone and get as much light and activity as you can for the next eight hours or so. Move this light exposure up by an hour a day until you’re synced up with your target schedule.
If traveling west, expose yourself to bright light in the one to two hours leading up to your normal bedtime in your original time zone, and keep getting light until you go to sleep or until about three hours before your usual wake-up time in your original time zone. Move this light exposure later by an hour a day until you sync up with your target schedule.
How is a sleep disorder different from being sleep deprived?
Think of sleep deprivation like hunger. There are many reasons you might be hungry. Maybe a medical issue is ruining your appetite, making it hard for you to keep food down, or preventing your body from properly absorbing nutrients. You might also be hungry simply because you’re skipping meals due to a busy schedule. Naturally, those problems require different solutions. In the same way, there are many reasons you might be sleep-deprived, including an unrelated medical issue, a sleep disorder, or because you just aren’t spending enough time in bed.
Not only do those three categories require different solutions but different sleep disorders will also require very different solutions. So, it’s not enough to just know that you’re sleep-deprived, my mission with the book is to help people pinpoint why they’re sleep deprived so they can then find the best solutions for their specific issue.
Finally, when should someone seek out a sleep specialist to determine if they have a sleep disorder?
Everyone has a bad night here and there, so that’s nothing to worry about. But if you consistently have trouble falling asleep, staying asleep, or you consistently feel sleepy during the day and you don’t know why, it’s time to address that issue. And while some sleep issues can be addressed at home, some will require professional help. Keep in mind that sleep specialists often have an area of expertise. For example, an expert in sleep apnea might know very little about how to treat insomnia. So, find a sleep clinician who has a lot of experience treating patients with your particular issue. Sleepeducation.org and behavioralsleep.org are both great resources, as are patient support groups.
Want more on how to get better sleep? Check out how breathwork can help you get a good night’s sleep.